It is indicated in adults and children of all ages for intrathecal (subarachnoid) spinal anaesthesia for surgery.
藥理
Local Anesthetic
Blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction
藥動學
Onset of action:
1. Epidural: Up to 17 minutes to spread to T6 dermatome.
2. Spinal: Within 1 minute; maximum dermatome level achieved within 15 minutes in most cases. Duration:
1. Epidural: 2 to 7.7 hours.
2. Spinal: 1.5 to 2.5 hours. Distribution:
1. Vd: (Infants) 3.9 ± 2 L/kg; (Children) 2.7 ± 0.2 L/kg.
2. Protein binding: 84% to 95%. Metabolism:
Hepatic; forms metabolite Time to peak, plasma:
30 to 45 minutes Excretion:
Urine (~6% unchanged); Clearance: (Infants) 7.1 ± 3.2 mL/kg/minute; Children: 10 ± 0.7 mL/kg/minute.
禁忌症
1. Hypersensitivity to bupivacaine hydrochloride, amide-type local anesthetics, or any component of the formulation
2. Obstetrical paracervical block anesthesia
3. IV regional anesthesia
懷孕分類
C
哺乳分類
Compatible with breastfeeding (WHO); Infant risk is minimal (MDX)
1. There are no specific dosage adjustments provided in the manufacturer's labeling.
2. Risk of adverse reactions may be increased in patients with renal impairment, particularly in patients with severe kidney disease. Consider increased monitoring for toxicities.
肝功能調整劑量
1.There are no specific dosage adjustments provided in the manufacturer's labeling.
2. Risk of toxicity may be increased in patients with severe impairment; consider a reduced dose and more frequent monitoring for toxicities in patients with moderate or severe impairment.